An ideal dressing method needs to have a certain absorption capacity, appropriate compressive hemostatic effect without affecting the blood supply of the tissues, as well as being easy to remove but not easy to dislodge on their own, improving the child’s postoperative comfort and reducing the pain of removal. Many reports have been published on postoperative dressing of hypospadias, and there is no uniform standard.

Various dressing methods are available such as a bacterial cellulose dressing, a multiperforated pellicle dressing made by polysaccharide, installing vacuum sealing drainage (VSD) after the use of Mepilex bandage, applying antiseptic cream of framycetin + gauze pieces + dressing with Dynaplast circumferentially all over the penis, using tubular finger oxygen-enriched oil inside the coated device, and using compound chamomile and lidocaine hydrochloride gel or autologous platelet gel [6,7,8,9,10,11]. Each has its own advantages and disadvantages. However, not all dressings are available in all countries, so finding the right one for your circumstance is the best option.

We derived the bandaging for Group B by drawing on the bandaging reported by Singh et al. [12]. In this method, involuntary erection of the penis can lead to elongation and retraction, which may induce retraction of the penile skin and lead to uneven skin force, thereby causing possibility of partial flap ischemia and necrosis. Similarly, if the dressing is excessively tight, it will lead to poor blood supply of the flap, which is thus susceptible to urinary fistula and incisional dehiscence. Postoperative dressing dislodgment may cause postoperative bleeding, and localized hematoma or formation of blood scabs can easily induce infection under the scabs, leading to incision cracking or urinary fistula [13].

MEBO (moisture-exposed burn ointment) is a Chinese burn ointment with a USA-patented formulation since 1995, which was developed at the China National Science and Technology Centre in Beijing in 1989 [14]. It possesses diverse pharmacological activities, such as clearing heat and removing toxins; promoting tissue regeneration; preventing adhesion, anti-inflammation, analgesia; and promoting wound healing. As a result, it has been extensively used in various disciplines, and its safety has been confirmed by many parties [15].

We applied 3 M antimicrobial incise drape + MEBO that can reduce postoperative pain (incisional pain or distraction pain to varying degrees) and discomfort in children and prevent detachment of the urinary catheter, which reduces the worries of the parents about their children. Meanwhile, it also reduces the clinical nursing burden. It is possible that the glans may not be visualized when the child has a small penis, but do not be concerned, as this type of dressing provides an even pressure on the penis and does not cause excessive pressure to cause glans ischemia, which was not seen in our study. 3 M antimicrobial incise drape + MEBO creates a moist physiological repair and growth environment for the wound after hypospadias surgery, keeps the wound in a moist state, and reduces the pain and discomfort caused by penile incision, which is also in line with the concept of wet healing proposed by Hinman [16]. This kind of moist healing environment between the wound and the dressing is mionectic, is slightly acidic, is close to the body temperature, and maintains the wound in a constant moist state that is close to the physiological state. This is conducive to the growth of the granulation tissue and the division and proliferation of cells, and may reduce the risk of blood scab formation, which promotes complete wound healing and shortens the time of wound healing [17]. Therefore, do not be concerned when it appears that part of the dressing is soaked with urine, as this does not affect the child’s comfort or the healing of the incision.

From our clinical observation, the following advantages are discovered from the application of 3 M antimicrobial incise drape + MEBO in the postoperative dressing of congenital hypospadias: a) This dressing method can achieve a good anti-adhesion effect, reduce the difficulty in dressing removal, and play a role in reducing postoperative pain, with good comfort. b) It maintains moist wound environment and contains certain herbal ingredients to promote wound healing. c) Relative isolation from the environment reduces the risk of infection and prevents the penis from being touched by accident, thereby providing the “helmet-like” protection. D) Reduces dilemma of whether the penis is in an erect state or not, and no dressing will fall off and does not cause rebleeding. e) The overall force on the penis is uniform, which does not easily impair the blood supply of the skin flap, and the overall appearance is satisfactory due to the mild postoperative glans and penis edema. f) It is inexpensive (costs about 30 CNY) and easy to apply.